Assessing a client’s current nutritional intake is important in order to obtain information on their consumption of energy, carbohydrates, fats and proteins as well as vitamins and minerals. It can also give an indication of any deficiencies they may have as well as their knowledge about nutrition.
In order to assess the current quality of the client’s diet, firstly you need to obtain information on what the client is currently eating on a daily basis. There are a number of ways you can do this.
Food record diary
A food record diary involves the client tracking everything they eat and drink for between four and seven days, ideally that period would involve both week day intake and weekend intake as it is common for nutrition to differ on weekends.
This type of food tracking can be done by weighing or estimating the amount of food eaten using cups and spoon sizes.
The diary can be tracked using a pen and paper but there are also many different applications to download onto phone which allow a client to type in the food they have consumed. These apps often have macronutrient and micronutrient details of thousands of different foods and add the client’s intake up over the day to give an estimated total of energy, carbohydrates, proteins and fats. This can also be useful for the client to learn from but it is important for you to emphasise that it is unnecessary for the client to track intake obsessively following their requested food diary. Some individuals can become reliant upon the phone app instead of listening to their hunger and satiety signals.
You can then use the details from the written food diary to input into a dietary analysis tool, such as a phone application or using a book to establish average intake of nutrients. This method is also good for analysis of whether intake of vitamins and minerals meet recommended guidelines.
A seven day weighed food diary is the gold standard of non-physiological or biochemical food analysis tools but you must be careful how they interpret it. The client may have altered behaviour consciously or subconsciously due to the fact they were recording their intake. Weighing foods is often a hassle for clients who are new to tracking food so it is important to note that this may not be accurate.
24 hour food recall
A food recall would involve you asking the client to talk about the food and drink they have consumed over the previous 24 hour period. Once collected, this information can be analysed for quantity of macronutrients and energy.
This method is dependent on the accuracy of the client’s memory and of their willingness to be honest about what they have consumed. If the client is aware they are overconsuming sugar or sweet food they may under report these foods. The results are also conditional upon the client being able to estimate portion sizes.
The food recall would require the client to trust you not to judge them, but it is a much smaller burden on the client than keeping a daily food record.
Food frequency questionnaire
The food frequency questionnaire, commonly referred to by the abbreviation FFQ, consists of a list of foods and selection options relating to how often these are consumed. The client simply needs to mark the frequency of the consumption of the food listed e.g. twice daily, weekly, fortnightly etc. You should inform the client to base it on the intake over the past three months to give a more accurate idea of their current intake.
You can prepare the list yourself using a variety of foods to capture the clients overall dietary intake, it should be composed of at least 150 foods. There are also pre-written versions available online. This method of intake is the least accurate of methods as there are difficulties in calculating the exact nutrients consumed due to no portion sizes stated, however it is quick for the client to perform and allows a general overview of the diet. The trainer should be able to see if any specific nutrients are deficient from this. For example, if yoghurt, milk and cheese are rarely consumed then the client could be deficient in calcium.
From all these methods you should consider;
How much of the client’s diet comes from processed foods and whole foods.
An estimate of total energy (kcal) intake.
An estimate of total carbohydrate, fat and protein intake.
An awareness of any nutrients the client may be deficient in.
The client’s knowledge and relationship with food.
The timing of meals and snacks throughout the day.
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